On the first morning of a family vacation to San Francisco in 2016, the parents 8-month-old son fell off the bed in the family’s hotel room and hit his head.
There was no blood, but the baby was inconsolable. So what do you do when your baby of not even a year old can’t stop crying? You take him to the hospital.
So the husband and wife called 911, worried that the boy might have something really wrong with him as a result of the short fall. An ambulance took the family San Francisco General Hospital.
The doctors at the hospital quickly determined that baby Jeong Whan was fine — just a little bruising on his nose and forehead. He took a short nap in his mother’s arms, drank some infant formula and was discharged roughly three hours later with a clean bill of health. The family continued their vacation, and the incident was quickly forgotten.
After getting home, the bill arrived. To their astonishment, they owed the hospital $18,836 for their visit lasting three hours and 22 minutes. The bulk of the bill was for a mysterious fee of $15,666 labeled “trauma activation,” also known as “a trauma response fee.”
“It’s a huge amount of money for my family,” the father said, whose family had travel insurance that would cover only $5,000. “If my baby got special treatment, OK. That would be OK. But he didn’t. So why should I have to pay the bill? They did nothing for my son.”
American hospital bills are today have tons of multiplying fees, many of which don’t even exist in other countries: fees for blood draws, fees for checking the blood oxygen level with a skin probe, fees for putting on a cast, minute-by-minute fees for lying in the recovery room.
But perhaps the biggest and most confusing is the “trauma fee,” in part because it often runs more than $10,000 and because it seems to be applied so anytime, for any reason.
A different California hospital’s trauma activation fee was $22,550 for a young man injured in a minor motorcycle crash. He suffered a cut on his head that required two staples and received some IV fluid and ibuprofen. No x-rays, scans, or bloodwork were done.
A trauma fee is the price a trauma center charges when it activates and assembles a team of medical professionals that can meet a patient with potentially serious injuries in the ER. It is billed on top of the hospital’s emergency room physician charge and…
… procedures, equipment and facility fees.
Hospital officials interviewed Vox defend the fee, saying it’s expensive to round up a trauma team and treat a patient, even if that treatment ends up being minor. Interestingly, the story quotes the person responsible for inventing the fee for the National Uniform Billing Committee. “To a degree, I feel like I created a monster. Some hospitals are turning this into a cash cow on the backs of patients.”
Hospitals are supposed to use discretion and downgrade the fee to that of a regular ER visit when appropriate, but many are clearly not.
Unfortunately, outside of Medicare and state hospitals, regulators have little sway over how much is charged. And at public hospitals, such fees may be a way to balance government budgets. At SFGH, the $30,206 higher-level trauma response fee, which increased by about $2,000 last year, was approved by the San Francisco Board of Supervisors.
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